Kidney disease is highly prevalent and results in premature mortality, comorbid illnesses, reduced quality of life, and substantial healthcare costs. Given the vast scope of the kidney disease epidemic, there is a critical need to train scientists who can conduct high-impact research that addresses this massive health problem. This proposal is a competitive renewal application, years 26 to 30, for a NRSA to fund our Kidney Disease Epidemiology and Clinical Research Training Program at Hopkins. The goal of this program is to identify and train scientists who have the potential to become leaders in the design and conduct of epidemiologic, clinical and translational research related to kidney disease. The Program is based in the Welch Center for Prevention, Epidemiology, and Clinical Research. It takes advantage of the faculty?s strengths in the application of rigorous methodology to study kidney disease; their ability to design interdisciplinary, high-impact research; and their dedication to education and mentorship. The program Director (Dr. Appel), Associate Directors (Drs. Fadrowski, Grams, Segev), and 14 other nationally recognized kidney disease researchers serve as core faculty, and another 11 faculty serve as affiliate faculty. An Advisory Committee of institutional leaders and accomplished researchers advise the program?s leadership and monitor its progress. Our training program has been highly successful. We have recruited exceptionally high-quality candidates, provided them with rigorous training, and helped launch their research careers. Over the last 15 years, we supported 31 post-doctoral trainees (77% women, 10% underrepresented minorities). Of the 25 graduates, 24 are pursuing academic careers, and the vast majority are scientists; 12 received federal grants (11 K awardees). The NRSA funding has established Hopkins as a pre-eminent academic center for the design and conduct of clinical, epidemiologic and translational research related to kidney disease; spawned new research programs (e.g. the CKD Prognosis Consortium and the Kidney Transplant Outcomes program) and new education initiatives (e.g. kidney disease epidemiology course); revitalized the Pediatric Nephrology fellowship; forged close collaborative relations across schools and academic units; and most importantly, produced a cadre of extremely successful young investigators who are doing innovative research at institutions across the U.S. Still, we will not rest on our laurels. With funding from this application, we intend to increase the size of our training program from 4 to 6 post-doctoral trainees, expand the core faculty (including luminaries recruited from other institutions: D. Brennan, C. Chute, and C. Parikh), and enhance trainee recruitment efforts, especially targeted at enrolling under-represented minorities. Ultimately, this T32 will meet a critical goal of NIDDK, i.e. broadening the pool of well-trained researchers conducting impactful kidney disease research.